401k Plan data: DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN plan

DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN
Plan identification number	501

DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

DENOVO VENTURES, LLC has sponsored the creation of one or more 401k plans.

Company Name: DENOVO VENTURES, LLC

Employer identification number (EIN): 510453048

NAIC Classification: 541600

Additional information about DENOVO VENTURES, LLC

Jurisdiction of Incorporation: Colorado Department of State

Incorporation Date: 2003-02-27

Company Identification Number: 20031065189

Legal Registered Office Address: 371 Centennial Pkwy Ste 220

Louisville
United States of America (USA)
80027

More information about DENOVO VENTURES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-01-01
501 2014-01-01

Plan Statistics for DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN

401k plan membership statisitcs for DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN

Measure Date Value
2015: DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 141
Total of all active and inactive participants 2015-01-01 141
Total participants 2015-01-01 141
2014: DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 173
Total of all active and inactive participants 2014-01-01 173
Total participants 2014-01-01 173

Measure	Date	Value
2015: DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	141
Total of all active and inactive participants	2015-01-01	141
Total participants	2015-01-01	141
2014: DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	173
Total of all active and inactive participants	2014-01-01	173
Total participants	2014-01-01	173

Form 5500 Responses for DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN

2015: DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	First time form 5500 has been submitted	Yes
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )

Policy contract number

Policy instance

Number of Individuals Covered	141
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $339,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AIG MEDICAL EXCESS (National Association of Insurance Commissioners NAIC id number: 19445 )

Policy contract number

P90

Policy instance

Insurance contract or identification number	P90
Number of Individuals Covered	141
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	ORGAN TRANSPLANT
Welfare Benefit Premiums Paid to Carrier	USD $22,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1039999

Policy instance

Insurance contract or identification number	1039999
Number of Individuals Covered	246
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $15,742
Total amount of fees paid to insurance company	USD $4,121
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $127,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,880
Insurance broker organization code?	3
Amount paid for insurance broker fees	4121
Additional information about fees paid to insurance broker	BONUS
Insurance broker name	WARNER PACIFIC INSURANCE SERVICES

HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )

Policy contract number

673312

Policy instance

Insurance contract or identification number	673312
Number of Individuals Covered	142
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,888
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $183,066
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,888
Insurance broker organization code?	5
Insurance broker name	PEAK BENEFITS

STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )

Policy contract number

Policy instance

Number of Individuals Covered	142
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $259,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AIG MEDICAL EXCESS (National Association of Insurance Commissioners NAIC id number: 19445 )

Policy contract number

P90

Policy instance

Insurance contract or identification number	P90
Number of Individuals Covered	142
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	ORGAN TRANSPLANT
Welfare Benefit Premiums Paid to Carrier	USD $20,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1039999

Policy instance

Insurance contract or identification number	1039999
Number of Individuals Covered	218
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $13,693
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $111,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,291
Insurance broker organization code?	3
Insurance broker name	PEAK BENEFITS

HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )

Policy contract number

673312

Policy instance

Insurance contract or identification number	673312
Number of Individuals Covered	136
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $5,517
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $139,564
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,517
Insurance broker organization code?	5
Insurance broker name	PEAK BENEFITS

Potentially related plans

DENOVO VENTURES, LLC HEALTH AND WELFARE PLAN [EIN = 464158868]

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Company Name:	DENOVO VENTURES, LLC
Employer identification number (EIN):	510453048
NAIC Classification:	541600

Jurisdiction of Incorporation:	Colorado Department of State
Incorporation Date:	2003-02-27
Company Identification Number:	20031065189
Legal Registered Office Address:	371 Centennial Pkwy Ste 220 Louisville United States of America (USA) 80027